2010 年至 2020 年美国剖宫产术后试产及成功试产趋势。
Trends in Attempted and Successful Trial of Labor After Cesarean Delivery in the United States From 2010 to 2020.
机构信息
University of Utah Health, Salt Lake City, and Intermountain Healthcare, Murray, Utah.
出版信息
Obstet Gynecol. 2023 Jan 1;141(1):173-175. doi: 10.1097/AOG.0000000000004998. Epub 2022 Nov 30.
The vaginal birth after cesarean (VBAC) delivery rate was last reported as 13.8% in 2019. However, contemporary trends in attempted and successful trial of labor after cesarean (TOLAC) delivery among individuals with prior cesarean delivery have not been evaluated. We performed a repeated cross-sectional analysis of singleton, cephalic, term deliveries in individuals with a history of one or two cesarean deliveries in the National Vital Statistics System from 2010 to 2020. Temporal trends in attempted and successful TOLAC, as well as VBAC, were characterized using joinpoint regression. Overall, 4,277,800 deliveries were included. Attempted TOLAC increased from 15.3% in 2010 to 21.7% in 2020, with an annual percent increase (relative) of 4.25% (95% CI 2.9-5.6%). Successful TOLAC increased from 69.8% to 74.7%, with an annual percent change (relative) of 0.91% (95% CI 0.7-1.2%). The VBAC rate similarly increased such that, by 2020, it was 16.2%.
2019 年，阴道分娩（VBAC）的比例最后一次报告为 13.8%。然而，对于有剖宫产史的人，尝试并成功实施剖宫产术后再次分娩（TOLAC）的当代趋势尚未得到评估。我们对 2010 年至 2020 年全国生命统计系统中记录的有一次或两次剖宫产史的单胎、头位、足月分娩的个体进行了重复横断面分析。使用连接点回归描述了尝试和成功 TOLAC 以及 VBAC 的时间趋势。总体而言，纳入了 4277800 例分娩。尝试 TOLAC 从 2010 年的 15.3%增加到 2020 年的 21.7%，年百分比增长率（相对）为 4.25%（95%CI 2.9-5.6%）。成功 TOLAC 从 69.8%增加到 74.7%，年百分比变化（相对）为 0.91%（95%CI 0.7-1.2%）。VBAC 率也呈上升趋势，到 2020 年，VBAC 率达到 16.2%。
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